1073806022 NPI number — ERICA HAN PA-C

Table of content: ERICA HAN PA-C (NPI 1073806022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073806022 NPI number — ERICA HAN PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAN
Provider First Name:
ERICA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073806022
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14140 SOUTHWEST FWY STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUGAR LAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77478-3842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-649-7000
Provider Business Mailing Address Fax Number:
713-484-6649

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 MCKINNEY ST
Provider Second Line Business Practice Location Address:
SUITE 415
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77010-2016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-650-3776
Provider Business Practice Location Address Fax Number:
713-752-2037
Provider Enumeration Date:
05/24/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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